“…it is now critical for physicians to reconceptualize SGLT2 inhibitors as organ-protective agents rather than glucose-lowering drugs.” This statement was made by a leading heart failure expert, Milton Packer, in a respected diabetes journal. SGLT2 inhibitors reduce the risk of hospitalizations for heart failure by 30% whether the patient is diabetic or not. “There is compelling evidence that sodium–glucose cotransporter 2 (SGLT2) inhibitors exert cardioprotective and renoprotective effects that are far greater than expected based on their effects on glycemia or glycosuria.” SGLT2 inhibitors protect the heart by activating AMPK. They impact the molecular biology than causes heart failure. They are precision medications.
The medications in the green boxes in the diagram also benefit heart failure. ACE inhibitors like lisinopril, ARBs like losartan, and mineralocorticoid receptor antagonists like spironolactone also indirectly activate AMPK and inactivate mTOR (the mechanistic target of rapamycin.) They impact the same signaling and are also precision medicines. When you combine the green box interventions in a protocol for diabetes, you reduce heart failure admissions by 70% over 21 year of follow-up while extending life by eight years compared with usual care. No other intervention produces that result.
Your protocol for heart failure with a reduced ejection fraction is therefore very simple. You give adequate doses of lisinopril, carvedilol, and spironolactone for $12 a month. If those don’t stabilize the patient with those medications, add empagliflozin. You won’t just reduce heart failure admissions. You will protect every organ and cell in the body. Let’s get started! wbestermann@congruityhealth.com 423-782-0372
That’s right. This was why I started my decades long journey to create Multifunction Cardiogram Technology to measure real physiological information of the cardiovascular system to advance heart disease early detection and prevention and better understanding of the causes of diseases so mankind can find real cure.